For part one of this story – all that happened going to Edmonton to have a supported birth – click here: The Journey to Lucas. Now brace yourselves, this is a long one.
On the morning of January 19th, I was wide awake at six, making sure I would hear my phone if it rang calling us in for an induction. Back home, inductions are scheduled for a specific time – usually eight a.m. or so – and you just show up at that time. If they’re too busy, they send you home until they can fit you in. At the Royal Alex, they tell you to be by your phone from six a.m. to six p.m. and if you don’t hear from them by the end of the day, you’ll have to wait for the next morning. We went to bed hoping it would either be first thing or wait until we had breakfast and could get the rest of the kids over to Mom and Dad’s hotel. I finally decided around six fifteen that I should get whatever sleep I could manage and then slept almost another two hours. We got up and had breakfast at the Guest Home and then made sure everyone had their bathing suits, a change of clothes and pajamas in case they needed to stay overnight at the hotel and then we headed to West Edmonton.
We figured since we hadn’t heard anything yet, we may as well take advantage of the pool and hot tub before we got a call. The hot tub was not insanely hot so I had a good opportunity to soak for awhile and to watch the kids enjoying the pool. As I mentioned in my last post, I had a thought around eleven thirty that it was possible that the hospital was calling our home phone number. I checked our messages and had one from them so I found a quiet place and phoned the induction and assessment ward. Sure enough, they had called me just after nine and again at eleven fifteen. The nurse suggested we come in at two and I agreed. She told us to have lunch and show up any time between two and three. We said goodbye to the kids and went to Red Lobster for a splurgy last meal before the induction.
We got to the hospital around two thirty and after some paperwork, I was put on a monitor for around forty minutes and given an IV lock. At the end of that time, they found baby’s heart rate had a few minor decelerations (very likely when he was moving a lot) so they put me back on it before moving forward with the induction. I was told by my nurse at the time that this was all due to my being a VBAC. Serious heart decels without recovery are a sign of rupture so they always have to be certain this is not happening. We were certain of that ourselves but felt a little trapped by policy so we put up with it for the next hour or so. I had been checked at some point and found to be no more than two centimetres dilated but soft enough that everyone figured the Foley bulb would not do much but just fall out. Pitocin was the only option on the table at that point.
During the waiting, I found out that they had no record of my GBS (group B strep) test from home, even though I had called our birthing centre and asked them to fax it two weeks prior. I had verbal confirmation that it was negative but they wanted proof on paper. So we waited awhile longer while they tracked it down. I had been drinking water leading up to the actual induction but was warned that I would be under a no food or drink order once the Pit was started. I knew this was based on outdated research and typically worked against women, but I wasn’t hungry at all after the huge lunch I had so I didn’t fight it. Just about every nurse and doctor I encountered said I could have ice so we stuck with that when I needed it. Thankfully hunger didn’t set in until after Lucas was born.
It was around six forty-five when they finally started me on the lowest dose of Pitocin. It was raised by a small amount every half hour and I started having contractions that were increasingly strong but not painful. This continued through being moved to labour and delivery and until around ten o’clock. There were a few times when the Pitocin was slowed down or turned down but the nurses kept turning it up because my contractions would space out a bit more. Personally, I feel now that I would have had an overall better labour if they had let them slow down and see if my body was taking over but it was hard and fast on Pitocin the whole night.
During the first few hours, I remembered the birth playlist I had made on Spotify of worship songs that had particularly spoken to me during pregnancy. I put it on and it stayed on until it ended and then another one played until well after Lucas was born. This may have been the first labour where I’ve actually had music playing and it was a very calming thing to have in the room, especially when things got more difficult later on.
I was still texting my friend at ten minutes to ten saying I was feeling fantastic with strong but not really painful contractions. I don’t know exactly when that changed but sometime between then and midnight, I started feeling pain and baby started having serious decelerations in his heart rate. It seemed again (like Simon’s birth) that position had something to do with it because it would recover if I moved onto my side or shifted somehow. My recollection of this time is very fuzzy, in part because I started relying on the gas to get me through contractions (sorry to any of you who don’t have access to laughing gas during labour – it’s incredible stuff). It worked amazingly well to keep me coping and let me rest between contractions. A few hours of that, however, and I was feeling totally exhausted and wishing it would all be over already. I had been at five or six centimetres for awhile without change and was starting to feel discouraged on top of being so tired. The heart rate decels hadn’t gotten much better either.
When we were first moved to L&D, the nurse taking us there looked over and said, “So, epidural?” in a positive tone like she knew I was going to say, “Yes, of course!” I looked at her funny instead and said, “Um, I hope not.” She told me I had to read the papers and that they would prefer I sign them then so I didn’t ask for it later when I was – and I quote – “writhing in pain.” I laughed, knowing it’s not like me to writhe in pain in any labour, and said I wouldn’t need it but I would read and sign them because it wasn’t an order for them, just consent if I changed my mind. I had no intention of changing my mind at that point.
Back to the gas, passing out, feeling exhausted, etc and I remembered a few birth stories where women had felt like I did, had good progress in dilation, then got an epidural, rested for an hour or so and delivered their babies. I heard God say, “Humble yourself,” and I knew what it meant. “This is totally out of left field for me, but I think I’m considering an epidural,” I told the nurse. She said we could certainly consider it since I was well established in labour but that the anesthesiologist was in the OR at the time. She put in the request and offered me some Fentanyl to get me through a contraction or two. It may have helped but I was still using the gas as well and the dose didn’t last long at all. It was during this time of waiting that I decided that my bladder felt full but I couldn’t do anything about it. I asked for a catheter, knowing that sometimes a full bladder can hold baby back from descending properly. The nurse said usually they would do that after the epidural but that it was probably a good idea to take care of it while we waited. I’ve had three catheters prior to spinals and while it’s not fun, I knew it wouldn’t compare to the contractions I was having and it might bring me closer to delivery. I was willing to try almost anything at that point. After the cath was in, the nurse started getting a second dose of Fentanyl ready when the doctor came in to do the epidural. This was likely around one thirty in the morning, although I was certainly not looking at the clock during that time.
I sat up, made it through a contraction or two and then endured the never comfortable experience of having needles put in your back. I’ve only ever had spinals for my cesareans and for Oliver’s birth when an ECV was needed and the OB wanted to be prepared for a cesarean. An epidural was basically the same experience but instead of immediately falling over numb, I was told it would take fifteen minutes to work. I laid down on my back to let it start working and baby’s heart rate fell drastically. I was moved onto my side to bring it back up but then told that the epidural would be one sided if I stayed that way so onto my back I went. Heart rate went down again and I rolled onto my other side. Meanwhile the epidural was definitely not working yet. At this point, I started to feel like pushing, which felt like the best thing ever after what I had gone through. A quick check was done and I was told I was only seven centimetres which meant, “Don’t push!” During the next few minutes (probably less than five), I fought pushing while we listened to baby’s heart rate drop and not recover. A scalp monitor had been put in sometime between the Fentanyl and the epidural and so we knew it wasn’t just the external monitor falling off my belly (something that happened all day and drove me crazy…darned continuous monitoring).
The on call doctor was there at the time and when the heart rate was fifty something and I was starting to feel things going in the direction of Simon’s birth, she checked me to see if I might possibly be fully dilated yet. I heard her say, “Seven,” and then, “Vacuum,” but didn’t put anything together right away. She then increased her volume considerably and yelled at me, “Okay, hold your legs up, hold your breath, get angry and push as hard as you possibly can!!” I was confused – she had just said I was still seven centimetres. What happened that I could push suddenly? Doesn’t she know pushing against a cervix that isn’t fully dilated can make it swell and stop labour in its tracks? She yelled again, “GET ANGRY! PUSH!!” and I did what I could. Not good enough, apparently, “NO! You have to hold your breath and push as hard as you can!” So I gave it my best, felt every moment of that baby’s head coming down and stretching and then suddenly he was out.
Mike looked down and whispered to me, “It’s a boy!” With how fast everything went, I just looked around and started saying, “What just happened?!” Lucas was put on my chest as soon as his cord was clamped and I marveled at him and the fact that I had just delivered him vaginally, despite having so much against us. Official time of birth was one forty-four a.m., meaning seven hours of Pitocin and probably around three and a half hours of active labour at the end.
I figured pushing had taken five minutes but Mike said it was no more than three and probably closer to two. Then I found out why I could push before the OB ever said, “ten.” She had checked, found me still at a seven and quickly decided to manually stretch me to ten centimetres and use a vacuum, rather than make the call to do another cesarean. Unlike most people’s assumptions, I did not feel anything other than what a normal cervical check feels like late in labour. I am so incredibly grateful for that quick and rather unconventional thinking. The nurse said afterward that any other doctor would have had me in the OR. Dr. Patel was apparently the only doctor who would do something like that. I’ve since learned that it’s not an uncommon practice for midwives to employ in certain situations like mine but is often frowned upon.
What amazes me still is that I flew to Edmonton in December to meet Dr. Mayo, someone rumoured to be fantastic about VBACs even after multiple cesareans. He then had surgery and Dr. Sklar took over. I saw Sklar twice during our two and a half weeks in Edmonton prior to the induction. During labour, I only saw the on call doctor on the assessment side, a resident, and Dr. Patel. We had prayed for the right staff to be there at the right time and in almost every case, it seemed that we had exactly that. With only one exception, all the nurses leading up to birth were kind and attentive and Dr. Patel was exactly what I needed at the end.
Because of the vacuum and the speed of delivery, I did have a second degree tear that was rather extensive. The resident stitched while the OB observed and coached but it still didn’t take more than fifteen to twenty minutes. The hardest part about that was not being in a good position to start nursing Lucas. He was calm through the whole thing but I always like to get them nursing as soon as possible.
Mike was nearly passing out tired through the last two or three hours of my labour, having an actual nap once or twice, and so once the stitching was done, Lucas was weighed and he had a chance to hold him, he said goodnight and went back to the Guest Home. It was probably close to three in the morning at that point. I stayed in the labour and delivery room long enough to nurse baby for awhile and then went downstairs to the postpartum ward. I very much missed the lovely all in one rooms we have at the hospital at home, especially the privacy, as I was roomed with someone else whose husband was snoring away in the recliner next to her and whose entire extended family seemed to show up the next day and stay almost the entire time. A shared bathroom with a rolling door that doesn’t lock didn’t help matters.
In all, we only stayed at the hospital around twenty hours after Lucas was born. We had to check out of the Guest Home the next day and I didn’t want Mike to have to pack up and get all the kids out without my help. I felt great aside from fairly minor pain from my stitches so it wasn’t hard at all to leave so quickly. We had some issues with birth registration that will take awhile to sort out, mostly because it’s done so differently in Alberta and I was misinformed at the hospital on how to fill out some of the paperwork. We spent two nights with Mike’s sister an hour away from Edmonton and then drove about halfway home on the twenty-third and came the rest of the way on the twenty-fourth, exactly three weeks from the day we drove to Edmonton. We spent thousands of dollars and it was easily one of the most challenging experiences we’ve ever had but we came home with a beautiful healthy baby and a successful VBA2C which was the entire reason we went away.
I know now that I should have probably avoided induction at all costs but we really did feel that we needed to get our family home. After adding up all we spent while we were away (including the van repair), I’m not sure we could have managed the costs of lodging any longer without burning through every penny of our savings and going into debt. We cannot change the way this labour went but if we have more children, it will likely change what we do then.
In terms of recovery, I did have to have a donut cushion to sit on for the drive home and made use of my lovely bathtub once I got here to have some Epsom salt baths but one week in and I wasn’t feeling my stitches anymore. That absolutely trumps six weeks of pain and tenderness after a cesarean!
Lucas is two weeks old now and an absolute doll. He is a peaceful baby and gets passed around all day, cherished particularly by his sister, who doesn’t mind another brother at all. I marvel a bit at having seven sons. Clearly God has a plan for us to raise up Godly men, and honestly, I’m a bit of a boy mom after having nothing but boys for twelve years. Jenny is a softening presence for her younger brothers and they have thoroughly toughened her up so she can handle a lot more than many girls her age.
One of the blessings of coming back was coming home to a very clean house, thanks to Mike’s mom, and to a stocked fridge and freezer, thanks to the ladies at our church. We haven’t received hot meals like every baby before this (although I think one or two may come yet) but haven’t had to be incredibly creative or shop much at all.
If you’ve made it this far, your reward is a picture of our sweet boy. He has so much hair and the sweetest little chin and lips. We can’t quite decide who he looks like just yet but like all our kids, I’m sure he’ll fit in without looking just like anyone else.