Zoe's labour story

After a healthy and uneventful pregnancy (we had one small scare when they were unable to see her bladder and thought she had hydronephrosis but we were never very concerned with it), I prepared to leave work for a year. Being from the States, it felt very odd to prepare for a year maternity leave. None of my friends had ever done it. It was always return to work in a three months or leave your job (some friends were not even lucky enough to get the 12 weeks off). Gavin and I were more than prepared. Our hospital bags and carseat were ready to go since week 36 (it was a good thing we installed it at that time since if we had waited any longer, I don't think I would have fit in the car to help with installation!) I was excited to leave work and to tell the truth, I was unsure if I would truly return in a years time. A big part of me always wanted to be a stay at home mom and was hoping Gavin would secure a permanent position during my leave time. All of that was a year off, so I just focused on getting ready for the birth.
So I worked until three days before the baby was due and began having contractions on and off soon after I left work. Silly me kept thinking "this is it!" especially after one event of contracting for twelve hours straight with the contractions happening closer and closer together. However, the contractions would eventually stop and I began to realize this is not it. I had to start going to the midwife pretty regularly (every few days at first and then every day in the end). The midwife told me I was already a few cms dilated and so I really began to think "this is it!" I come from a very large family with lots of births every year and they are all healthy and uneventful for the most part. So, although I knew about getting induced or C-section, I never thought those things would be part of my baby's birth plan.
And so the week passed with me going to the midwife for stretch and sweeps of my cervix (just about as comfortable as it sounds) and us trying every trick in the book to convince the baby to come on out. I even bundled up (remember this was February in Canada) a couple of times a day and waddled around the neighbourhood until my feet were numb hoping that the activity would start labour. Now we know that kids with 1P36 lack the muscle tone to initiate the labour process. Although my body was doing its job- I was 4cm by the time I was induced, Zoe was just not programmed to come out yet.
After I was ten days over due and feeling pretty anxious, I went for an ultrasound to see how the placenta and amniotic levels were doing. We knew the baby was fine since Zoe was always very active and kicked me non-stop. We also had our own stethoscope and listened to the heartbeat several times a day. So we assumed that all would be well. At that ultrasound we found out two things. One, the baby was very small for its gestational age- they estimated it was six pounds three ounces. Two, the baby had something seriously wrong with its heart. The heart defect they thought the baby had was fatal and it was most likely not going to survive the birthing process. We were told to go home, relax, enjoy the weekend, and then show up on Monday to be induced if I had not gone into labour before that time. Because the baby was so small, they wanted to give it as much extra time as possible to build fat and strength before inducing me. The good news was that the placenta and amniotic levels were fine, so for now the baby was in the best place it could be.
To say we were devastated just doesn't really explain how we were feeling. After having so many normal ultrasounds where the baby was a perfect size, we were confused. Why it had suddenly stopped growing? Was it the heart defect? Is that why the baby was so small? If the baby survived birth, it had a 75% chance that it would die in the first few days. We didn't know what to do. Do we tell people? Do we just "relax and enjoy our weekend, haha?" In the end we decided not to alarm our families. Since we weren't 100% sure of what was going on, we decided to hold off. We spent most of the weekend crying, listening to the baby's heartbeat while crying, eating while crying.....you get the picture. We also continued our attempts at inducing labour.
Monday morning we showed up for another ultrasound and the tech was the same one from Friday. He looked horrified and said, "Why are you still pregnant? You should have been induced." Then the tech called in someone else who happened to know someone at Sick Kids and was able to set up a fetal echo for us. So, we would be able to find out exactly what was going on with the baby's heart before birth. That way, if birth would be too much stress on the baby's heart, we could plan a C-section. We had five ultrasounds that day and heard a few different hypotheses thrown around as to why the baby was small and what was wrong with the heart. The fetal echo showed right ventricle hypertrophy (thickening of the heart muscle) and we were told that at most the baby would spend a few days in the hospital and would be fine. We were overjoyed by this news. We now know that this was partly correct, but Zoe had five other heart defects along with the hypertrophy. The last ultrasound of the day we were able to see the baby peeing. It was kind of cool, despite the fact that we were so exhausted by that point.
Meanwhile, there was a gasket in an OR room that blew. What this meant was that the hospital we planned to birth at, the hospital my midwife had rights at, was not inducing anyone. When you start an induction, there is always a chance of needing a C-section. So, we were not able to start induction that Monday. People kept reassuring us that the placenta and fluid looked good which is why they did not consider the baby at risk so they could put us off another day or two. Someone mentioned returning Friday for induction and I think I shrieked at them "Are you kidding me!" Yes, I knew the baby was technically fine, but I also knew the risk of staying pregnant past 42 weeks. Our midwife (I can not say how glad we were to have midwives at this point and later) advocated for us to start induction on Tuesday. So, we left the hospital on Monday with a plan to return Tuesday. As a last ditch attempt at starting labour, I took caster oil that evening. The only thing it succeeded at was cleaning out my bowel! No contractions.
Tuesday we returned to the hospital with our bags packed and feeling quite anxious to get this all started. We wanted the reassurance of seeing that the baby was fine and to get a proper echo right away to find out what was really going on with the heart. We ended up sitting around the hospital all day Tuesday and were told to return at midnight (some emergency pts had shown up and therefore we were bumped).
We went home for a few hours of sleep. Returning at midnight for the induction was surreal. We parked at Sick Kids since it is right across from the hospital I would give birth at and we now knew that the baby would be transferred to Sick Kids after birth. The hospital was deserted and there was so much snow on the ground, I felt like we were on a movie set. They lock the doors of both hospitals that face University Ave which meant that a normally 5 minute walk took us about 20 mins. I was jogging and sweating up a storm and thinking "If this doesn't start labour, I don't know what will!"
After finally getting settled in our room, a doctor came to tell us that the induction would not be starting at midnight. The reason we were given is that all of the NICU beds were taken and if the baby needed any resuscitation after the birth, it would be very dangerous without the NICU bed space. At the time we were very annoyed at this reason, but given how Zoe did need resuscitation and the NICU bed after birth we are now very grateful for this doctor for being so careful. At this time (and earlier in the process) we were given the choice to go to another hospital. We loved our midwife and felt completely comfortable with her care. We did not want to switch hospitals because she would not be able to follow us. So, we decided to get some sleep. Even our midwife slept at the hospital with us that night. She did not want to miss the call if they suddenly gave us the green light to go ahead.
The next morning (Wednesday), our midwife advocated for us to move into one of the swanky new birthing suites. It had a tub room, TV, etc. Not that we cared at that point. And because I was hooked up to pitocin the whole time, I wasn't able to walk around much or use the tub room. The extra room did come in handy when the repository therapist and doctors had to rush in when Zoe was born.
At noon on Wednesday, when I was 42 weeks plus one day, the pitocin was finally started. It finally hit me that I was going to be induced after all and I cried. I know, how could I just be getting it right? I guess up until that point I still hoped that I would go into spontaneous labour. I did not want pitocin because I did not want an epidural or pain meds. I decided to go without both despite the pitocin and I can tell you that was not a good idea. I know labour is never comfortable or much fun, but pitocin without drugs was more awful that I thought it could be. I have a high pain tolerance. Anyway, I will spare you the gory details. Many of us have been there, done that. I can say it was way more painful than I counted on but it made it all worth it in the end when I overheard a NICU doc say that it was a good thing that "mom didnt have any drugs on board because this kiddo was born so flat. Who knows if the kid would have made it if her apgar was any lower." And so, the pain was worth it because although we thought Zoe was dead when she was born, she was not and who knows if drugs would have caused her any problems. Or maybe I would have needed a C-section and I can't imagine coping with post-partem recovery of a C-section on top of being by Zoe's side in the NICU.
So that is the story of Zoe's labour. There was some other random things I was barely aware of since I was in so much pain. At one point there was a chemical spill and so the pitocin had to be stopped. The plus side is that I was able to unhook from the IV and get a hot shower which felt really nice and helped with the pain. Also at one point, a friend from work brought us some lunch (had I called her? I can't remember) but it was really nice of her to bring us food. So, thank you Cathy!
We will post more about Zoe's birth story later. I just want to say a huge thank you to my midwife, Robin. The back up midwife, Joyce. And the midwife student, who I can't remember her name even though she got up close and personal with me by holding my leg during the pushing faze (it is amazing how you don't care who sees you at that point!) Our midwives were awesome in all of their support during the pregnancy, labour, and after. They even got us tea and toast while we were waiting to hear how the baby was. And they visited us and Zoe in the NICU several times. I don't know any obgyns who would have taken such care of us physically as well as emotionally.