Birth Story Part 1 – The Induction (That Wasn’t)

I finally managed to cobble enough time to get this post written. Since it’s long enough as it is, it’s not the complete birth story (the baby does not actually arrive until the next post).

Before I go further, I should clarify something about dates. All along in this blog, I have been using a due date of June 7th, which is consistent with the date that my fertility clinic gave me. However, my OB has been using a date of June 10th. Since the decision as to when to induce was made by my OB, his due date is the most relevant date for the birth story, so that is why in this post my pregnancy seems to go in reverse.

June 19th  (41w, 2d) – 11AM

Final OB appointment – Dr. says it’s time to induce. I go home and wait for the hospital to call me in once they have resources available, which could happen at any time over the next few days.

Feels like the longest day ever.

June 20th (41w, 3d)

Still no call from the hospital. I start wondering whether they actually know they are supposed to call me, or if I’ve fallen through the cracks and am waiting for nothing. Time slows down even more (did not think it was even possible!).

June 21st (41w, 4d) – 1AM

I am in the bathroom getting ready for bed when my phone rings. Yes, it is really 1AM, and yes, it is really time to go kick things off.

By 2AM, I am in labour and delivery triage getting a cervical check by the resident Dr. As expected, nothing is happening, so I get cervadil gel inserted which is supposed to help ripen my cervix and get it ready for labour. The plan is that once I am dilated enough, they can break my water and we can go from there (assuming I haven’t gone into labour on my own in the meantime).

I am monitored for an hour to make sure baby’s heartbeat looks good, then sent home and told to return in 12 hours to check progress (or sooner if my water breaks, the cervadil falls out, or I go into labour).

June 21st (41w, 4d) – 2PM

I feel mild to moderate cramping in the morning, which gives me hope that the cervadil is working. I can’t believe that this is actually happening! We go back to the hospital for our progress check, however when I describe the sensations I’ve been having to the Dr. in triage, she does not look impressed and says she does not expect that we’ve made much progress. The cervical check confirms her suspicions, so after another hour of fetal monitoring, I am once again sent home and told to return in 12 hours.

June 22nd (41w, 5d) – 1AM

The cervadil falls out an hour early when I go to the bathroom, so I wake my husband up and we walk over to the hospital (after the last visit, we stayed at my mom’s house which is conveniently located right across the street).

On the way into the hospital, we run into the husband of the woman who came in at the same time we did the night before with contractions. She had her baby not too long after we saw them. We also run into a couple from our birthing classes, and the female is having some serious contractions. I’m tired, but otherwise feel perfectly normal. “I’m not in labour, I’m being induced” I offer as explanation as to why I don’t appear to be in pain at all.

We have the cervical check, and once again the verdict is the same – no progress. We’ve done what we can with the cervadil, so the resident Dr. explains that I will now be admitted to the hospital for the next stage in the induction process. After consultation with another Dr., I learn that the next step will involve inserting a foley catheter (a little balloon filled with water that should mechanically expand my cervix), and hooking me up to pitocin, which should bring contractions on.

However, before we can get going, we’re back to waiting for a room to become available, so spend the rest of the night resting in triage.

June 22nd (41w, 5d) – 8AM

Finally at 8AM, we get moved to a room in labour and delivery. The nurse explains what’s going to happen next, and checks some vitals. Shortly after we settle in, my OB pops in to visit, and in his usual blunt way explains where we stand:

“I know you feel like you’ve been at this a while now, but since the cervadil did not work, it’s like you’re starting from scratch – the last few days don’t count.” He then warned that I now had “2 strikes against me”, since I had not gone into labour on my own, and the cervadil did not work, so with continued intervention attempts being required, my chances of ending up with a C section are now about 50/50.

June 22nd (41w, 5d) – 10AM

Just before 10AM, the nurse and Dr. working that day come in to tell that there has been a change of plans:

“We’re not going to start the pitocin right away. Instead, we’re moving you to the high risk unit and only doing the foley catheter for now. We’ll check you in 6 to 8 hours and if nothing has happened yet, we’ll start the pitocin at that point.”

I ask why I’m being moved to high risk, and the answer from the Dr. is: “Frankly, because we need this room.” While this is getting a little too familiar (and not in a good way), I am happy to delay the pitocin, which scares the hell out of me. As it is, I’m already dreading the pain and exhaustion that comes with labour, and all the reading I’ve done has prepared me to expect faster and harder contractions with pitocin than what would happen naturally. So I’m all about taking things slow with the interventions and hoping that the catheter will be enough to get things going.

The foley is put in, and I felt quite crampy right away. We move all of our bags to the room in high risk, and I am given instructions to walk as much as possible to put pressure on my cervix and hopefully speed things along. My husband and I spend quite a bit of time walking around the ward.

June 22nd (41w, 5d) – most of the rest of the day

We are pretty much back to waiting. Periodically, the nurse checks on me to check my vitals and hook me up to the monitor to track the baby’s heart rate and my uterine activity (ideally contractions). Since she sees we’re interested, she shows us how the read the monitor. The top tracing shows the baby’s heart rate, which should fall within a highlighted range, while also jumping around within that range. The bottom tracing shows my uterine activity, and the nurse explains that a contraction would show up as a low, gradual hill pattern. However, all I get is periodic spikes which correspond to the baby kicking me, or otherwise moving around.

At every check the nurse asks me if I am feeling any contractions or cramps, and how much pain I am in. Initially, all I feel is the constant, dull cramping from the catheter. I estimate the pain at 1.5 to 2 out of 10. The nurse is not impressed. As the day goes on, even that pain goes away. Once in a while, I do feel a little crampy, so report this to the nurse, but again, I can tell that 3 (not very painful) crampy moments an hour is not what she is hoping to hear.

Ideally, if everything went according to plan, the catheter would fall out once my cervix was sufficiently dilated, however this is not happening. At some point, my husband goes to get some food, and comes back to report that the couple from our birthing classes who we’d run into in triage the night before had their baby about an hour and half after we saw them.

Not that I’m counting, but both couples who we saw in triage over the last two nights now have their babies, while we continue to wait. I know it’s irrational because we are so close to meeting our baby too, but I have a flashback to that familiar feeling while struggling through infertility: “Why can everyone else have a baby so easily and I can’t?”

June 22nd (41w, 5d) – 8PM

Finally, after about 10 hours, the resident Dr. comes to check on me and confirm that the foley is still in tight. Therefore, once a room becomes available, I will be moved back to labour and delivery to start the pitocin. In the meantime while we wait, she suggests that I tug on the catheter periodically to see if it’s loosened up at all. I do as suggested, but each time, it feels as tight as ever.

June 22nd (41w, 5d) – 11PM

We finally get the word that they are ready for us in labour and delivery, so it’s time to once again change rooms, hopefully for the last time before our baby comes. I’m nervous, but resigned to the fact that I do really need the pitocin to make this happen, and ready for something to finally happen.

To be continued…