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Claire’s Birth Story

April 29, 2013

It Begins

2:00AM, Sunday March 31, 2013

It was the middle of the night, and Nicole woke me up to tell me that she had just had her third bowel movement in 20 minutes. Something was moving. I asked Nicole if she was having any “pressure waves” – our word for contractions. She replied that she was now feeling Braxton Hicks contractions coupled with cramping, but they didn’t feel like pressure waves. (Braxton Hicks contractions are normal, sporadic uterine contractions that are also known as “practice contractions.” Nic had been feeling them for months.) In my sleepy haze, I wanted to believe that the birthing time had not yet begun, but I decided to start timing these “Braxton Hicks cramps” nonetheless. The Braxton Hicks cramps (BHCs) were about 7 and 15 minutes apart. Nicole pooped three more times, making six within an hour. All of these were solid, real poops, she assured me. By 4:00AM, the bowel movements had stopped, and the BHCs were coming less frequently. I didn’t think it was worth calling the hospital, so we went back to sleep.

7:15AM, Sunday

Our alarm jolted us awake only a few hours later. We had planned a day trip to Nanaimo for Easter. Although Nicole was almost 39 weeks (8 and ¾ months) pregnant, we had felt that a trip to Nanaimo via seaplane was feasible. It was also sentimentally important. Kathryn (Marty’s partner) had been in palliative care at Nanaimo Hospital for several weeks, Justine (Nicole’s youngest sister) would be back home, celebrating her 25th birthday, and Marty (Nicole’s dad) would be cooking an Easter turkey for lunch. The seaplane would fly only a few hundred feet in the air, the trip would take 15 minutes, and it was a safe and efficient way for Nicole to travel. As we walked to the Skytrain station at 7:30, Nicole phoned the midwives at South Community Birth Program (SCBP) to check in. Our doctor had already approved our trip, and the midwife on call cleared us for the short flight, despite the recent BHCs. She understood the importance of this trip to the family, and reassured us that the baby could be born at Nanaimo hospital, if necessary.

Little baby seemed to like the flight…no contractions in the air!

Nanaimo-venture! We landed at 9:00AM, and began our whistle-stop tour. We picked up Justine’s birthday cake and visited Kathryn at the hospital. Marty and I played Goaltimate while Nicole and Justine tossed the frisbee.  The girls headed home early to finish the last minute lunch prep. We had a terrific Easter/birthday meal at Marty’s. I picked stinging nettles to make into pesto. Finally, we headed back to the hospital and had an Easter egg hunt in Kathryn’s room, before catching the 5:30 seaplane back to Vancouver. All the while, Nicole quietly weathered the Braxton-Hicks cramping.

Who says you have to be a kid to have an easter egg hunt? This one was in Kathryn's hospital room!

Who says you have to be a kid to have an easter egg hunt?

Back in Vancouver

It was a beautiful, sunny day full of blossoms during our adventures!

It was a beautiful, sunny day full of blossoms during our adventures!

By the time we arrived home, it was 6:00PM and Nicole’s BHCs were becoming more frequent. We had dinner plans at a friends’ place, so we headed out on our bikes for the 15 minute ride. Nicole reported that her BHCs were getting stronger, but they didn’t prevent her from riding. At the BBQ, our friend Lindsay suggested that Nicole should consider timing these “BHCs”, or whatever they were,  which I did, for the first time since 4:00AM. They were coming five to fifteen minutes apart, and we remained uncertain as to what this implied. Should we go home and start getting ready for the hospital, or stay for one more beer? The reader will probably guess where each one of us stood on the question. Eventually, I accepted that this baby was probably on its way, and we should head home. Our friends Jonny and Larissa offered many times to drive us, but the ride back would be downhill and easy. I think we were both also in denial, not believing that our lil’ Hermit was coming already, and fearful that we were not yet prepared. Back home, I unaccountably decided to make pesto. Lots of pesto. All of it from stinging nettles I had picked the weekend before, and in Nanaimo that same day.

Making nettle pesto...

Making nettle pesto…

Nicole supported the idea as a quick task, but after an hour and a half, she had lost patience. Finally around 11:30, with the cooking and packing complete, and our midwife confirming we should come to the hospital, I called a cab. It was 11:37PM.

In between pressure waves, James wanted one last photo of the belly!

In between pressure waves, James wanted one last photo of the belly!

Driving to BC Womens, we found Vancouver’s streets empty.  The cabbie had known as soon as Nicole sat in the back seat that a baby was coming, and to our surprise, this wasn’t new to him.  So much for our assumption that while Nicole put on headphones and turned her mental “lightswitch” off during pressure waves, we would be incognito. At the Hospital While I paid the cabbie and grabbed our stuff, Nicole pressed the hospital after hours buzzer to be let in. Unfortunately, this was followed immediately by a pressure wave, so she was doubled over and unable to respond when the security guard answered the call.  The pressure wave passed and she was able to communicate to the confused guard that she was in labour, and we were finally admitted. After we finished the hospital paperwork, our fabulous SCBP midwife-on-call (Lena) checked Nicole’s progress. She was already at 4-5 cm – halfway to pushing! This confirmed that our progress on the Boulevard of Breech Delivery was under way.

Our baby's breech position.

Our baby’s breech position.

If we wanted to achieve a vaginal birth, Nic had to meet many time-sensitive milestones. She had to dilate about 1 cm per hour, and once she reached 10 cm, she only had one hour to push. We would also be forced to move to the delivery operating room before pushing, in case an emergency caesarean was necessary. Nicole knew what she was getting herself into, and, thanks to months of natural birth preparation (Hypnobabies), she was ready. During her appointment three days earlier at the Best Birth Clinic, Dr. Whitehill told her she was a candidate for a vaginal breech delivery, so we were hopeful for a natural birth. When Nic had asked about delivering without an epidural, the clinicians told her this would be cruel and unusual punishment, but Nicole hoped to prove them wrong. Around midnight, our doula Yvette arrived on a wave of energy and enthusiasm. As a Hypnobabies instructor herself, she knew all the birth-management tools we had spent weeks practising. As the next pressure wave built up, Nicole turned her “lightswitch” off, swayed her hips to focus, and Yvetted jumped into action. Her support proved crucial during our adventure.

James supporting my belly during a pressure wave as I swayed my hips.

James supporting my belly during a pressure wave as I swayed my hips.

The waves were coming more quickly now, and were lasting longer. All around Nicole, health care workers were buzzing. One nurse connected Nicole to an IV and the anesthesiologist inserted a needle in her spine for the epidural, if she needed it. Throughout the poking and prodding, Nic tried to stay focused on the pressure waves. She would stand and hold onto my shoulders during each one. Between waves, she swayed her hips, and we danced to our bachata and salsa music. Eventually, the obstetrician-on-call arrived. OB: “So you want to have a vaginal breech delivery?” Nicole: “Yes.” “You’re sure you want to go through with this? You don’t want to have a caesarean?” “Yes, I’m sure. “Ok, if that’s what you want to do, here is how it’s going to work: you’ll be pushing and delivering in the operating room, in case we need to do an emergency c-section. You will have to lie on your back, and hold your breath for each push. You’ll also be in stirrups.” Nicole had never heard these last three conditions before, and her mood changed. We showed him our Hypnobabies birth techniques sheet, and he replied indignantly that these would not be possible if he was to deliver our baby. Nicole began to have doubts about a natural birth. It was now about 1:00AM.

Awaiting the tap for the epidural.

Awaiting the tap for the epidural.

Nicole kept laboring until about 3:30, but she had only dilated to 5-6 cm. In order to speed things up, her delivery team decided to break her waters. The effect was immediate: the pressure waves started coming fast and furious, and much stronger than before. So strong that she could no longer hold herself up during a wave, and had to lean on me for support. By 7:00AM, Nic was at 10 cm, and the pushing waves were starting.  The doctors asked her not to push, and instead focus on breathing to bring the baby lower into the pelvis. Time to Push! By 7:45, the nurse finally gave us the green light to move to the OR, and Nicole practically started running, her IV pole in tow. As I gathered our things, I heard the nurse plead with Nic to slow down and let her catch up! Over a dozen doctors, residents, and nurses poured into the OR. All met the same sight: Nicole on her hands and knees, on the floor next to the bed, letting her pushing waves ease the baby out.

In the OR: the only time Nicole was grateful to have an IV, because it was something to hold onto during the pressure waves.

In the OR: the only time Nicole was grateful to have an IV; it was something to hold onto during the pressure waves.

She was still on all fours when a nurse announced that the obstetrician’s shift had just ended, and our new OB would now be Dr. Rosengarten.  Nic was in the middle of a pressure wave, and let out a scream of relief. We had met Dr. Rosengarten at an appointment a few weeks earlier, and adored him immediately. Mark Rosengarten was the best there was; we later found out his secret nickname was “birth ninja”, because of his incredible skills. In this one moment, all the doubt and fear that had built up with our previous obstetrician was replaced by the realization that Nicole could do this. To make the point, when Rosengarten arrived in the OR a few minutes later, he held up a surgical mask and asked his team: “Are we going to need these? Nah, I didn’t think so.” He threw the mask to the floor, effectively announcing that this delivery would not require surgery. Rosengarten gently coaxed Nicole onto the operating table, and onto her back. He showed Nicole how to hold her legs to her chest, with nurses supporting her. The baby’s bum was just about to appear. Then, the anesthesiologist arrived It turns out that the top doc in an OR is the anesthesiologist. He turned to Rosengarten, and told him that although Nicole might not want an epidural, he needed to connect it immediately, just in case. Rosengarten responded that the epidural would not be necessary. Surprised, the anesthesiologist shot back that if he did not connect it now, it would be too late to use it later. Rosengarten replied that the baby was coming now, and Nicole (who didn’t want an epidural anyway) would not need it. With that, the anesthesiologist left the room.

Time to push!

Time to push!

The bum started to appear. Deep purplish-red, it would emerge briefly, only to retreat after each contraction. Slowly, over the course of several pushing waves, Nicole eased the bum out. Then, the legs, folded in a pike position against the chest, came out one by one. Two more big pushes brought out the mid-section, up to the shoulders. Rosengarten turned the baby clockwise to get the first shoulder out, then counter clockwise for the other. Only the head remained when suddenly, the pushing waves stopped. This is the greatest concern with breech deliveries. In a normal delivery, the largest body part (the head) exits first, and the rest of the body slips easily out. When the baby is upside down, the cervix senses that the birth is finished after the body is out, and it begins to contract while the head is still inside. Nic could no longer feel anything below her waist, and accused the doctors of giving her an epidural! They assured her that the epidural tube was not connected, and told her she had to trigger another pushing wave. They told me to kiss Nicole, to try and help the process, because kissing can promote the release of oxytocin, which stimulates uterine contractions.  And so, with about a dozen people around the operating table, I started making out with my wife. I told her it reminded me of our wedding ceremony. The kissing helped, but it wasn’t enough, so the doctors told me to start massaging Nicole’s nipples. I obliged, but Nicole quickly interrupted our smooching session. “Don’t massage on top of the gown”, she insisted, “put your hand under it!” A few moments later, a slow pushing wave began. Nicole buckled down, held her breath, hollered, and pushed harder than ever before. She pushed so hard that we later noticed burst capillaries around her neck and face, and a minor hemorrhage in her eyes. The nurses held her legs down, while the doctor used forceps and a hand to get around the baby’s head. In the final moments, a small episiotomy allowed the head to move, and it made a popping sound as it emerged with the cord and a lot of water. The doctors cut the cord and rushed the baby to the pediatrics table to administer oxygen, a normal procedure for a breech vaginal delivery. A few moments later, we heard the first cry, and, soon after, found out our little hermit was a she. With his hands now free, Dr. Rosengarten grabbed our camera and starting taking pictures.

It's a girl!

It’s a girl!

After about 5 minutes, the pediatricians gave the green light that her breathing, heartbeat, and blood oxygen levels were normal. Our SCBP doctor Kiran brought our little baby girl back to Nicole, and we named her Claire.

Claire's little breech legs

Claire’s little breech legs.

Comfy in Dad's arms.

Comfy in Dad’s arms.

One happy family!

One happy family!

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5 Comments
  1. Laura Spencer permalink

    Amazing! Thanks for sharing. I feel like I was there through the whole experience.

    Can’t wait to visit again soon!

    xo

    On Mon, Apr 29, 2013 at 1:32 PM, spencerrank

  2. Love you guys!! thank you for sharing your story!

  3. Thank you so much for sharing this detailed story of your birth. It’s an amazing story for women considering breech birth to read!

Trackbacks & Pingbacks

  1. Breech Birth: What you want to know — Birth Takes a Village

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