By Vicki Hsieh
In the 28th week of my pregnancy, a month before Christmas, and much to my annoyance, I was diagnosed with gestational diabetes. It aggravated me that I could no longer stuff my face with overgenerous slices of cake at the end of a long day. It irritated me even more that I was diagnosed with being only 0.1 mmol/L over the fasting value. Nevertheless, I was enlisted with the diabetes clinic at Women’s and Children’s. The nutritionist supported me in my last ditch attempt to get my fasting value down by following what seemed like an Atkins diet – lots of protein and fats, and only a very small amount of carbohydrates, but it had little effect on my fasting value, and I consistently came in 0.1-0.2 mmol/L over the cut-off most mornings. I felt defeated, but resigned to taking insulin. On the one hand, it was important for the long-term health of my baby, not to have elevated glucose levels through the nights and yet, insulin injections could mean that my placenta may start to deteriorate and I would have to have an induced labour if baby wasn’t getting enough nutrients in those last weeks. I was checking in at the diabetes clinic weekly and also attending weekly non-stress testing at the hospital. Baby appeared to be progressing normally, showed a lot of activity, and had a healthy heart rate with good accelerations. I was scheduled for an appointment with an OB in the 38th week where they would review my records and determine if induction was necessary for that day. I was petrified of the cascade effect of interventions we learned about in class, and made an effort to advocate for a natural birth as long as the baby was still thriving in my uterus and my placenta was functioning well. I didn’t want to force labour if baby wasn’t quite ready yet. I’m not sure if it was my apprehension about decision day on January 18th that baby could that she decided make her entrance into our world on the 17th!
4am on the 17th of January (two weeks before my due date) I woke up to some aches and a small gush of fluid. I had been displaying some bloody show the week before. My body and mind were hyper aware of every little ache and pain and I felt like the baby was wanting to come very soon. I got up to pee, the aching subsided, and I climbed back into bed and waited to see if the aching would return. After about 20 minutes, sure enough this dull aching crept back into my belly. At this point, I thought about how most considerate women I’ve heard about didn’t distress their husbands right away. They let them get a good night’s sleep, or even focus on those last few tasks before sounding the alarm. As I lay there in bed, I counted 5 minutes, looked at my watch and thought, this is not me – I’m all about sharing the pain and I’m sure he’ll get over it. I tapped Nik on the shoulder and said plainly “I think the baby is coming today”. In turned slightly, and in his half-asleep state he murmured “ok” and fell back asleep. Good, at least there wasn’t any panic in his voice.
6am We got up after an hour of light dozing. I got dressed, took my readings, and had my allowable half a cup of oatmeal and milk for breakfast. It was a busy morning of prescheduled appointments, starting with the diabetes clinic, non-stress testing, and the midwives. I figured, since we were seeing the whole slough of healthcare professionals that day, no need to call in about thinking baby may come. I’ll just tell them at the appointments. Besides, pre-labouring is a long, long process. Nik made arrangements with work to take the day off so that he could drive me to the appointments in case it got difficult to move around and drive for me.
7:30am By the time we got to the diabetes clinic in the morning my contractions were still mild and about 20-30 min apart – still very early stages if at all. I could be Braxton Hicks for all I knew. We were all so new to this! I was feeling great and mobility wasn’t an issue at all. The diabetes clinic was the same as it always was. The nurse grimaced, as always, when she had to review my daily values spreadsheet that I insisted on recording and printing using my phone app instead of writing out by hand.
“This might be the lucky day that you finally get rid of my me and my annoying push for technological advances in your world”, I thought as I handed in my bright red duotang. At my appointment with the specialist, I let him know that I thought I might have the baby the same day. He raised a brow “and what makes you think that?”. I told him about the fluid. I said, I wasn’t sure, but thought that might have been my water breaking and that I was having regular contractions that were about 20 min apart – in that there’s still lots of time, so not to worry. He got a little excited, maybe even a little frantic which I thought was strange – I naturally assumed that he dealt with this kind of situation all the time. He took all of my vitals, checked the position of the baby, measured me, hailed a nurse, and insisted that we register at the labouring department. He nervously recanted a story about a patient once that was 9cm dilated that had come to her appointment and nearly had her baby in his office. I assured him, that this wasn’t going to happen with me – I was far from ready to drop a baby, never mind in his office. Despite being perfectly capable of walking on my own, the nurse came back with a wheelchair and insisted that I be accompanied into registration – “probably some interdepartmental liability thing”, I bemused.
Registration was located in a bit of a grim corner of the hospital. We were signed in and placed in a bed space enclosed by out-dated dusty, rose coloured curtains. With all this kerfuffling about, we had missed the appointment for the non-stress testing, and we were clearly going to miss our appointment with the midwives across town. The hospital contacted our midwives and they agreed to come down to the hospital to have our regular appointment there and to assess how I was progressing.
As it turned out, I was 2-3 cm dilated when the midwife checked me and we decided to do a sweep to help things progress. The midwife reassured us that we didn’t need to be as excited as the doctor in the diabetes clinic just yet. We had a good laugh about it all.
I asked her if my water had broken. I wasn’t sure if the fluid earlier in the morning constituted water breaking as I had never experienced it before and I remember from class that it isn’t usually Hollywood-esque, but more of a trickle. My water hadn’t broken, we still had time, and I was fine to go home. She did say that we might be back later in the night.
We were given instructions to call when my contractions were 6 minutes apart and lasting for 1 min and for 30 min or longer. The midwife wanted to get me on Penicillin for 30 min before delivery as I tested positive for GBS. We got discharged and headed home for a bit of a nap as the morning turned out to be more eventful than I was hoping for. The contractions were becoming more achy and I was keen to curl up in bed. We stopped by Shopper’s on the way home and I picked up some Epsom salts on sale thinking I might try it out later in the bath. It was after all, a cold and dreary day, and the idea of a hot bath seemed salacious.
We got home, and I tried to get a nap in first, but my stuffy nose from my cold, and the achy feeling in my belly left me uncomfortable and restless. At this point, my contractions were around 12 minutes apart and the dull pain was becoming more prominent. I tried stretching out my back in bed, I reviewed our prenatal handbook and tried a bunch of the pre-labouring positions we learned, but still couldn’t get relaxed enough to nap. Finally around 2, I gave up on the comforts of bed, and decided to draw a bath, light a candle, and find some meditative music on my new subscription of google play. As soon as my bum hit the water, my entire body relaxed. Breathing in the Eucalyptus and Mint oils in the salts seemed to ease by congested nose. I turned off the lights in the bathroom and leaned back in the tub. I chuckled t to myself – I’ve been so busy with my life over the last few years, that I never really took the time to enjoy this tub we put in. It felt like a little slice of heaven, bathing in this Home Depot purchase. Why hadn’t I done this earlier?
The bath was so soothing and relaxing, I spent the next 4 hours in there. I’m sure I drifted off a few times in between contractions. I found it so much easier to breathe through the contractions in the dark and with the funny music for some reason. I had my fitbit on a chair by the tub so that I could keep time. The contractions were building in intensity, but I kept telling myself – there’s a point to all this – just think of all the oxytocin, endorphins, and adrenaline you’re making. I just concentrated hard on deep, controlled breathing and visualized an expanding circle. Don’t ask me how I came up with that – I think I might have watched one youtube clip about meditation and visualisation and decided that maybe I’ll give it a try.
Poor Nik was a little concerned for me, but probably felt pretty helpless about how much he could actually do to help me with the contractions. I think he spent most of the afternoon folding laundry in the other room and would periodically check up on me. I don’t remember this – but at one point he came in, maybe he told a joke to cheer me up and asked me if I needed anything. Apparently I said something to the effect of “I just need you to f**** off right now”. We both laughed and he left me to my own stubborn devices to get to hurry up and the good part!
I reached the 5 min mark, I called the midwife and told her what a great bath I was having and where my contractions were at. She said that judging by how calm I sounded and how jovial I was on the phone, there should be enough time for her to grab a bit to eat before heading over and was that ok? I said sure, why not. No point in heading into her night shift on an empty stomach.
The midwife arrived and found me shrivelled up like a prune in my glorious tub –I gave her a brief update, stopping mid sentence to breathe through each contraction. I was now averaging 2 and a half min between each contraction and just over a minute on each contraction. The midwife seemed surprised that I was able to get this far on my own just breathing. In my mind, I wondered – what else could I do but breathe, focus, and wait.
I wasn’t exactly feeling up to doing too much else that day. I told her I didn’t want to waste her time and call her in until I knew I was ready. I was frightful of going to the hospital prematurely and having to wait it out in the lobby or be stuck going back and forth between home and hospital for the next 24 hours. I would much rather tough it out at home, where it was safe and comfortable, until I was ready.
When the midwife examined me, I was 8 cm and she laughed that there shouldn’t be any problems with admittance. She started to hurry a little and said she was going to drive to the hospital ahead of us to pre-admit us, but if anything changed we could call her and she would turn around. I thought the last bit was funny and a bit strange. Maybe she was just cracking a joke, I mean – come back and what? Deliver the baby in the car? I laughed it off inside as the midwife hurried off.
I thought about getting dressed as another contraction came on and decided that my tacky plaid fleece pyjamas would be just fine for getting there. It’s not as if the nurses would judge me or that I really cared at that point. I waddled carefully over to the shoe cupboard to grab my shoes and ‘whoosh’ I felt as if a balloon had popped and all of Niagara Falls was descending down my legs and into the cupboard. Ok, so make it tacky, plaid pyjamas that were now soaked in amniotic fluid….it just keeps getting better! Another contraction – I doubled over into the cupboard from the pain and was now on all fours breathing into a pair of sweaty gym sneakers. I couldn’t find the strength to stand up and called out to Nik who was busy grabbing the hospital bag. Slightly horrified, he tried to help me up by lifting me under my arms. I had this overwhelming sensation to hang there in limbo in his arms, my legs not able to decide what to do or where to go. Should I change my pyjama pants? Another contraction – no, screw it. Having abandoned all thoughts of modesty, we stumbled down the hall to the elevator battling 2 more strong contractions along the way. We got in the elevator and I have a sudden urge to start pushing. Oh no! I turn my head around like an owl and survey the 70s fake wood panelling, and grey linoleum floors of the elevator. This is grim. No, not here, please. Breathe. Hold it in. 1 more contraction as we’re about to get out. Nik has to hold the elevator door open as I breathed through it. Ok, next hurdle – the parkade. Even more grim with the dim lighting and the cold, wet, concrete. “Also, not the most intimate setting”, I think as I lean on the bumper of our car to get through another contraction. The last thing I wanted was to give birth in the parkade as all of my neighbours show up parking their vehicles after a long day at work. I inched my way along the body of the vehicle. Nik puts down a towel for me on the seat and we drive off to the hospital. I find it much too intense to sit on anything so with my right arm holding the lever above the door frame, and my left hand pushing myself off the seat, we go. The contractions growing even stronger and it feels like we’re driving through a school zone the whole way. It doesn’t help that there’s an accident at Broadway and Main either. I close my eyes to focus on relaxing my muscles and trying my hardest not to push. Every once in a while I peek out of my right eye to see if we’re almost there. Nik makes a left on Cambie. Ugh, I’ve been hinting to him over the last month that turning left onto Oak would be much faster. I want to say something, but think – ok, now is not the time to be a backseat driver. At least he’s here to drive me. Just close my eyes and keep my mouth shut.
We get to the hospital and Nik rushes in to grab a wheelchair for me. As I hastily position myself onto the wiry, unpadded wheelchair, I think to myself – oh that’s why the wheelchairs have no cushion – because of women like me who have soaked through their pants. Makes perfect sense now! I had been wondering why the hospital was so chintzy on the wheelchairs when I saw them the weeks past.
The hospital was eerily quiet when we reached the desk. The midwife met us as promised, and wheeled me up to the 4th floor. “Is there a tub?” I ask. “I’m in love with taking baths. I think it would be very helpful”. The delivery nurse confirms that it has a tub. For some reason I feel massively relieved by this. As I get wheeled in, I feel really hot and sweaty. The nurse starts to gesture about the tub. I glanced quickly at the tub in the bathroom and then back at the bed. My mind was saying “tub” but my body was shouting “BED” so I threw my clothes down and made a concerted effort for the bed as the next contraction came on. Everything about how lying down for contractions was harder on the body and not the way our bodies were designed to give birth ran through my head, but reality was that my body was willing me to push hard and lying down felt the most powerful and least uncomfortable for me. In fact, my body yearned to push even harder! I had an overwhelming desire to pull up on something and the nurse and midwife were really quick in finding a bar and fashioning a cloth onto it. I could pull up on the cloth and really curl inward with the contractions. Nik was right by my side the whole time and was very calm through it all and his encouragement was just the right amount and at the right times. I checked with him a few times to make sure he was doing ok through this whole ordeal. For some reason, it never occurred to me that the hospital bed wasn’t actually a huge structure and that despite not wanting to be at the goal end, standing next to the bed, and looking down from overhead elicited more of a view than one may have bargained for. I was relieved that there were no signs of possible fainting from Nik. He was there, and very much into the labour as I was. Less than an hour of pushing had passed. The nurse and the midwife kept telling me that we were making great progress and baby was moving closer with every push. To me it all felt the same. I couldn’t really judge whether she was closer to coming out or not. When they said they could almost see her head, I thought they were just trying to encourage me. I asked for the time and they said it had been almost an hour. “Gosh”, I said aloud, “this hurts a lot and is pretty tiring. I know I said I wanted to try natural, but I don’t see myself being able to keep this up for 10 hours. Is it too late to ask for drugs?”
The midwife and the nurse gave each other an amused look. “Don’t think there’s enough time for that, my dear. It takes 30 min and you’re almost there.”
3 more pushes and the midwife tells me “after this push, I want you to wait for my cue to stop pushing and we’re going wait”. I finished the last push and before she could give me the cue to stop, the baby shot out – “literally torpedoed out” as Nik puts it. Both she and the nurse were caught a bit off guard. There was this feeling of calm and they placed baby on me right away. Nik announced the sex – we had a delightful baby girl! They asked if I wanted a jab to speed up the birthing of the placenta, but at that point, I figured the hard part is done, what’s a piddly placenta going to do. I declined, and the placenta came after 15 minutes or so without breaking a sweat. Nik cut the cord after it finished pulsating, noting that the consistency of the cord was chewy like calamari. Somehow Nik went from not being keen on cutting the cord when we had discussed this before, to being more than fine with it and joking about the whole situation he found himself in. So much so that the midwife sensed his fascination and followed up by giving us a biology class on the structure of my placenta afterwards. It was great! After the biology lesson, and being stitched up, it was just the three of us – tired, happy, and amazed by this surreal experience.
Ella May Burrows was born at 8:14 pm on January 17th at 6 lbs 7 oz.
Every day with our daughter has been a real blessing and we cherish every tear, smile, and bum rumble she brings us.
Vicki Hsieh is a proud graduate of the Childbearing Society’s 2016 Fall 5 Prenatal Series.