Tuesday, March 27, 2012

Granny Has A Midwife Crisis

Back in the day when I was having babies, there was no such thing as cellphones, digital cameras and facebook. Even owning a video camera and/or VCR was only reserved for the most high tech people. (And my children are not yet thirty.)

In the final weeks of pregnancy, part of the preparations included ensuring you had a roll of quarters so that after the birth, the father could walk down to the end of the hall and use a payphone to make the big announcement. The first call the new dads usually made was to their mother.  That was the honour of being Grandma.

Over the years, I've witnessed changes to technology, society, the design of the hospital. I'm not sure if hospitals are the same everywhere, but here in our town, babies are no longer born in small institutional-looking rooms that try to accommodate Daddy in a corner with perhaps a rolling chair for accessories. No, todays mothers have a birthing unit. A large almost homey room with a fridge, TV, private phone and second bed for attendees. The private ensuite has a jetted tub and fabulous shower.

No longer is the labouring mother restricted to only having the father coach her. It is very common these days to have a specified friend or a doula coach the labour while daddy is there for support, and the maternal grandmother there capturing the moments on digital camera or perhaps streaming a play-by-play to social media via a smart phone.

Even with all the comforts and freedom, it is not often that the paternal grandmother attends the birth. This factor makes my role as labour coach for my daughter-in-law even more of an honour.

Anyone who knows me, knows I love my role as Granny as much as life itself. I love that I got the honour of coaching Xander into the world three years ago. And I was equally looking forward to and feeling blessed that I was going to play the same role again three years later.

***
Enough of the preamble.

***
My second grandchild was due March 17, 2012. St. Patrick's Day. Appropriate, since Mommy loves all things Celtic. Although they chose not to have Xander's gender determined before birth, they were hoping to find out with this one.

The ultrasound was inconclusive, but they suspected it was a girl. And her name would be Maeve. An Irish name meaning either "Faery Warrior Queen" or "Intoxicating". Not "alcohol" intoxicating but "She who intoxicates" - The cause of great joy.

One cannot count on a suspicion so they were also prepared to love and cherish a baby boy. His name would be Trey. Turns out this is the English variant of the Irish name Traigh which means "strand or cord". It's also connected to the number three.

In December Jade was diagnosed with "borderline gestational diabetes." She did amazingly well at controlling her diet and testing her blood numerous times a day to ensure it did not develop into full-on gestational diabetes. Thus avoiding the complications that include larger-than-average sized newborn, low blood sugar in the baby's first weeks and higher risk of mother developing diabetes later in life. Large gestational diabetes infants often need to be delivered by c-section - a huge fear for Mommy. I don't think it was the actual c-section she feared, as much as the epidural needle in her back.

***
WARNING:
Details of labour and delivery are forthcoming. If you are not into that, you can leave now and Google UFC, World of Warcraft, The Hunger Games or whatever else you may find entertaining to your delicate senses.
***

The March 17 due date came and went without so much as a contraction. Physical exam determined the cervix was zero percent effaced and less than 1cm dilated. The doctor swept her membranes to no avail. This was repeated a few days later, and induction was scheduled for Monday, March 26th.

Thursday the 22nd Jade and Xander spent the afternoon at my house visiting with Nikki (my co-worker) her 8-day-old baby Avery, and Heidi, Nikki's mom. Little baby Avery seemed to do the trick, and Jade began having mild and irregular contractions.

These contractions continued sporadically through the night. At 7AM Friday morning, Ken called to say that although the contractions were still quite mild, they were coming fairly regularly about 5 minutes apart, and she'd had a bloody show, so we were going to head to the hospital to get things checked out as soon as Xander awoke.

Monitors, examinations and "whooshing machines" determined that early labour was setting in but the cervix was dilated less than 2cm and only slightly effaced. Contractions slowed to eight minutes apart and were still relatively easy for Jade to walk and talk through. "Go home and walk it out," was the prescribed action.

Xander stayed at our house for the day while Mommy and Daddy walked. Then Mommy napped. And everything slowed right down. There were still some contractions but they were very erratic and not all that strong.

It was best that Xander stay the night with us to simplify things should labour begin in earnest during the night. I was just getting ready for bed just after 11 when Ken called to say that the contractions were still quite inconsistent but currently about 4-6 minutes apart and getting painful when they did come. Jade wanted to go in and get something for pain. A check for progress would be good for a morale boost. Eighteen hours of contractions that seemed to be going nowhere were getting frustrating and Mommy was getting tired.

The main doors of the hospital are locked after 8PM and one must enter through the Emergency room and trek through the hospital to the labour and delivery wing. During this walk the contractions increased to every couple of minutes and were strong and painful. Definitely no walking and talking going on! Jade had 3 or 4 contractions on the walk from ER to Maternity.

Yes! My Granny heart began to leap with excitement. This is it! We about to have a baby. Being a labour coach is one of those things that make you experience contrasting emotions. The thrill and excitement of the miracle of life that is unfolding before your eyes being dashed by the pain you witness your loved one experiencing.

Surely all this pain and the past 18 hours will mean we will be at 8 cm. Nope. Three. Three!?!! That sucks. It's a hospital rule that they won't keep you in until you are 4cm or more.

"Oh, I have such a long way to go!" Jade declared as the nurse sunk a 6-inch needle full of morphine and gravol into her right hip. After giving morphine they keep the mother for half an hour to monitor her then do another cervix check before sending her on her way if she is not yet 4cm.

Laying on the examination bed, contractions dropped to 6-8 minutes apart.

I tried to disguise my own dashed hopes as I encouraged her. "Remember with Xander you got the morphine at 3 cm, went home and slept for 5 hours and woke up in the full-on transition part of labour."

Inside, I was fervently (okay, I don't really even know what that word means, but I think it fits here) praying and hoping that she would hurry up and dilate at least one more centimeter before the nurse returned to check her.

My hopes disintegrated as I watched the morphine reduce the contractions to 12 minutes and then 20 minutes went by without a contraction. That's the kicker with morphine, it either speeds things up or slows them down. It worked with Xander, but we got the short end of the straw this time.

After 45 minutes the nurse returned to say she was sending us on our way. There was no sense even going through the uncomfortable procedure of checking the cervix since things had come crashing to a standstill.

We used a wheelchair to push Jade back through the hospital towards the emergency room. Ken and I were wishing we'd gotten to partake in a sampling of the morphine so we could also see Jade's adoring fans that were apparently lining the hallways as she gave them a queenly wave from her rolling chariot. I wish I had videoed it. It was a nice little piece of comic relief to ease our disappointment.

"Well, let's get some sleep until 5 and then go back and get the job done," I encouraged Jade as I dropped them off at home before heading home for a nice big glass of wine.

I did get some sleep between 1 and 3:30 but it was light and broken as I kept one ear awake listening for my phone and the other ear on guard listening for Xander as he often wakes up in the night to pee. He did get up at 3:30 but went right back to sleep when I tucked him in after he peed. I laid awake, but exhausted, for half an hour.

At 4:32 my phone rang. "Are we ready?"

"Looks like it," was Ken's calm response. Jade hadn't really slept much and the contractions were getting quite intense. The morphine had worn off and she wanted either more of it, or to get this child out of her. Probably both.

"I'll be there in a few minutes. I will have to get dressed." They live 6 doors down from us so the drive to get there is short.

I figured this was probably the real deal so I'd better brush my teeth and do my hair. And what the heck, throw on some eyelashes. Making her wait one extra contraction wasn't going to make much difference. It was about six minutes from the phonecall until I was driving down the driveway.

I expected to see them standing on the deck, perhaps having a quick smoke, when I arrived. Instead I saw her dad standing there having a smoke. This didn't entirely surprise me. Grandpa Ron returned from Australia to stay with Ken and Jade a couple of weeks before baby was due. He is often awake at this time chatting with his wife as it is her evening time. That and I figured he was probably awakened by the commotion and excitement in the house. He too, was having a grandchild. This is exciting stuff!

I waited for what felt like forever, but was less than a minute, I'm sure. Ron waved me over. I got out of the car but left it running so the seats would continue to heat. Temperatures had dropped to about minus seven.

I didn't fully comprehend what Ron was saying to me, but I caught "Her water broke...."

I stood there thinking, "Silly girl is probably feeling bad, not wanting to get in my vehicle if she is wet."

"Just go in." Ron said with a firm voice.

I headed towards the door thinking Jade is probably changing her clothes and is going to be a while.

Their home was built in the 40's I think. It's small and dark. There is no light in the hallway that has a plywood floor. The lights in Xander's room and the bathroom were on and the doors were open. I turned the corner all I could see was Jade laying on the floor on her side, pants wet and shoes on. Ken was nowhere to be seen.

My heart stopped.

"I can't stop pushing!" Jade hardly got it blurted out before another contraction overtook her.

"Puh! Puh! Puh! Breathe it out. Good girl. You can do it!" We breathed together.

"I can't stop it!" she yelled, and then relaxed as the contraction ended.

Ken appeared around the corner with the phone he'd gone to the bedroom to retrieve extended in his hand towards me. I did not have time to savour the moment, but let me tell you, I have never in my life seen my son so glad to see his mother.

They had been putting their shoes on to come out and get in my vehicle when Jade's water broke. She felt the baby coming with the gush of water. "Call 9-1-1!" she screamed as she dropped herself to the floor. He ran for the phone and that's the moment I came on the scene.

I fumbled with the phone I was unfamiliar with in the semi-dark and managed to dial 9-1-1.

"911. What is your emergency?"

"My daughter-in-law is giving birth!" I'm not sure if I sounded as frantic as I felt. Perhaps I sounded worse.

"Stay on the line. I will help you. What is your address?" I gave her the information, knowing she was located somewhere in Kamloops, totally unfamiliar with my city. "Stay on the line. I will put you through to Prince George dispatch. Stay on the line!" she emphasized.

"All agents are busy. Stay on the line," a computer told me.

I screamed back, "How can all agents be busy! I called 911, not Telus!"

An agent answered within 8 seconds. But it was a long 8 seconds. Like a bull ride.

After losing precious seconds answering the necessary "Is she full term?" "Is she laying down?" "Did she have complications during pregnancy?" questions, she assured me help had been dispatched and were on their way.

"Do not try to stop labour. Do not try to stop the baby's head from coming out. Do not try to hold her legs closed."

"Can you see the baby's head?"

"I can't see anything, she's fully dressed." I responded as I tried to help Jade pant resistance to the contraction that was overtaking her. Puh! Puh! Puh!

"Remove her clothing from the waist down."

Ken and I do this when the contraction ends.

"I can see the head." I decide it's too trivial to tell Jade I can see the dark hair she is hoping this baby will have.

The agent reassures me and reminds me to stay on the line until the paramedics arrive. She gives me updates on their location. I repeat them to Jade. "We need to be ready for baby in case it arrives before they get there."

I bark orders to Ken as I get them from the agent. Get towels! We need a clean blanket to wrap baby in!

Jade's legs are shaking violently. I try to hold them steady while holding the phone to one ear. She interprets this as me trying to hold her legs together to delay the baby coming. "Let go of my legs!" she yells at me with panic in her voice.

The agent tells me to make sure we have a piece of string or a shoelace to deal with the umbilical cord if necessary. Ken is standing still. Inside my head I yell at him, "Don't just stand there. Get something!" Then I realize he can't hear the agent's instructions unless I repeat them. He runs for the laces that just came with his new work boots.

With the next contraction I can fully see the top of the head. The cord is coming first. I don't know what my first thought was, but I'm pretty sure it included, "Oh shit!" It is running right down the middle of the head. Sliding it off one way will free it, the other way will loop it around the neck. I refuse to be responsible for this decision and tell Jesus it's up to Him to choose.

The contraction ends and the head recedes a bit.

The ambulance is coming down Westwood.

From somewhere in the recesses of my brain I recall someone extolling the virtues of midwifery by including the fact that they massage the perineum to reduce the chances of tearing. With no idea what I was doing, I just used movements that felt most natural. If you can call massaging your daughter-in-law's perineum natural.

Another contraction begins and my massage action sweeps across the cord as the head begins to protrude again. And it dissipates. I realize this is in fact not the umbilical cord but a ridge of mucus and such that was built up when the head receded and the opening retracted. Whew! Relief washes over me.

I can see the ambulance lights. I snap at the agent on the phone. "They are here but they aren't coming in!" Of course, not thinking they needed time to ensure they were at the correct house, back into the long driveway and get their vehicle stopped.

This final contraction squeezes baby's head out as the paramedics rush through the front door with my son hailing them in with a nervous, "Hurry, the head is born!" I scooted out of the way while the first guy there took over and another handed him the suction thingy. (Suction thingy. That's an official medical term.)

At 4:56, as the body is expelled from the only wet warm environment it has ever known, the second batch of emergency personnel burst through the door. With it they bring a gust of minus 7 temperature straight towards the wet little baby bum which is facing upwards. She is wrapped in towels and blankets to protect her from the cold air before we can turn her over to determine gender. Her squeaky gurgling cry brings tears to everyone's eyes. Grandpa Ron is overcome with emotion in the background.

"Is it a boy or a girl?" Mommy inquires with a voice that is part laugh and part cry.

"We don't know," is not exactly the most comforting answer. I can't imagine what was going through her mind wondering what's wrong with her baby that they can't tell if it's a boy or a girl.

The attending male paramedic handed her off to the woman paramedic who had just arrived. She ducked into the bathroom to wipe her down, assess her health in a little better lighting and determine, "You have a little girl!" And she handed her Jade for a quick cuddle.

(As a side note - Granny's massage tactics were successful and there was no tearing and no need for stitches. Thanks Dee for your previous tidbit of into!)

Granny ran to her still idling vehicle to grab her iPhone to snap a few pictures for memory's sake. Or evidence or something. I dial PaPa on my way back inside. "We had a girl. At home. On the floor. In front of Xander's bedroom." I don't remember his response. Even I didn't give birth that quickly. And I was fast.

It was still dark and the photos I got show more reflection on the paramedic's safety clothing than detail of the birthing procedure, but hey, we'll take what we got. And what we got was the most perfect little angel, Maeve Liliana 6lb 13oz, 19.75 inches long at 4:56AM on Saturday March 24, 2012. Thank you Jesus.


8 or 10 paramedics cram into the small house to assist in Maeve's dramatic birth.





Daddy gets a quick cuddle. He also got to carry her during the ambulance ride.




Getting another check-over before loading up for the ride to the hospital.





Granny gets a better glimpse of her pretty little face.



A little bit of calm settles in.



Big brother, Xander, gets his first introduction to his sister - after telling Mommy for weeks that she was having a girl and she was going to pop out at home.






Mommy Lovin'


Snugglin' with the boys


Chillaxin' in the bath at 4 hours old.




Our beautiful little Faery Queen. Xander calls her Pixie Poo.














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