The Finish Line

At approximately 10:30pm on Wednesday 24th February, at gestation of 37 weeks and 4 days, my water broke. As it was late in the evening, and everything appeared normal, I did not phone my midwife until the next morning. This is standard practice so that they can be at their best when they need to be later in your labour, as they are likely not needed until at least the next day. The advice if early labour starts at night is to try and rest, and monitor any contractions. While I didn't get much sleep due to my brain running overtime, I did not experience any contractions overnight.

After speaking to my midwife on Thursday morning, and them learning that my water had broken but I still had not felt any contractions, they asked me to meet them at the maternity ward of the hospital for an examination. On arrival they hooked me up to a monitor consisting of probes strapped to my stomach, one that measures the baby's heartbeat, and one that detects contractions. After 20 minutes of continuous monitoring, no contractions were noted, and the heartbeat was healthy. My midwife then performed an examination of my cervix, which was still closed, and took swabs of the fluid still leaking to confirm that it was amniotic fluid and that therefore my waters had broken (apparently sometimes urinal incontinence can confound things, but thankfully that hasn't been an issue for me). The initial swab test came back as a weak positive, and subsequent a test confirmed this. The concern with the water breaking before labour commences is that the amniotic fluid is sterile, and is what protects the baby from infection. If the baby is not born within 24hrs of the water breaking, then IV antibiotics are administered to the mum to protect the baby. I was advised to return to hospital that evening if nothing had changed, to be admitted to receive antibiotics and to begin the process of inducing contractions.

Upon admission to hospital, I had an IV inserted and a midwife performed another examination of my cervix, and assessed my readiness for labour (I wasn't; cervix still closed, baby not in position, but still leaking amniotic fluid). She applied a prostaglandin gel behind my cervix, the purpose of which is to help soften the cervix ready to thin and dilate for birth. This alone can sometimes be enough to bring on labour, but more often is used as a precursor to a synthetic oxytocin IV drip, oxytocin being the hormone that drives labour. The next morning, after being seen by the obstetrics team and discussing the plan, I was moved to a birthing room and once again hooked up to the monitor. Following a continuous half hour of monitoring to check on the baby and confirm there were no contractions yet, at around 11:30am the midwives looking after me began the drip. I was also given the first dose of IV antibiotics, which were to be given every 4 hours until the baby was born. As the monitor showed no contractions, and I wasn't feeling any, the oxytocin dose was increased every half hour.

My midwife, who had been busy with another woman she was caring for, popped in and established that even though I couldn't feel anything, if she palpated my abdomen she could actually feel that I was undergoing some contractions that the monitor had not been picking up. With some adjustment they managed to get the monitor to work, and even though I felt nothing I was apparently having  6-7 mild to moderate contractions per 10 minute period. This was not ideal, as this can be indicative of hyperstimulation, where the contractions were too many and too small to actually progress labour, and can begin to cause distress to the baby. Thankfully my baby was not showing any signs of stress at all. The decision was made to reduce the oxytocin dose again, with the intention of reducing the frequent contractions before increasing the dose to hopefully bring on fewer, stronger contractions to dilate my cervix and bring about labour. After nothing really changing despite reducing the dose for a couple of hours, the midwives upon consulting with the obstetricians decided that since there were no signs of distress to the baby, to just continue ramping up the oxytocin dose for a few hours to see if they could just bring about bigger contractions. During the course of the day, I was advised not to eat, and to limit fluid intake 'just in case'. After several fruitless hours, and a further check confirming no change to my cervix, at around 7:20pm the call was made to perform an emergency caesarean section. The baby was still not in distress, but since it had now been almost 48hrs now since my water broke, they had to get her out somehow! Thankfully my lack of pain and the fact that the baby was still doing well meant that I wasn't feeling particularly stressed about how things were going, just getting frustrated at the long day of waiting to see when and how my baby would arrive.

The anaesthetist and obstetrician both met with me briefly to go over the procedure, risks and consent paperwork. Since I hadn't required an epidural, I was to have a spinal for the c-section, where anaesthetic and morphine was injected into my lower back, bathing the spinal cord and numbing my body from that point down. We were prepped for theatre almost right away, and at 8:17pm on February 26th 2021 our beautiful baby girl was born. My abdomen was obscured from my view with a curtain during the surgery, but they showed her to me as soon as they pulled her out, all shrivelled and purple, before briefly taking her aside to perform checks, and let Dave cut the remaining section of umbilical cord. They administered a vitamin K injection, which is standard procedure as babies are born with low vitamin K, which can put them at risk of a bleeding disorder. They put a nappy on her, then placed her on my chest for skin to skin contact and covered her with a blanket. It sounds cliché, but the moment she was given to me, I had the overwhelming feeling that everything was going to be ok. My heart rate, which had increased when they announced they were ready to start the surgery (mostly because it finally hit me that we were about to have a baby), immediately dropped to closer to normal as I relaxed. 

Dave and I could not be prouder or happier that two years since starting this journey, our baby girl is finally here. Perfect, healthy, and free of the SCA3 gene.

Our wee family of three