We would like to introduce Nahlyn Sewbarath Ram, who was born April 8, 2018 at 7:11am. This is my third Sunday baby. According to astrology, those born on Sundays are never satisfied with the ordinary and shine with brilliance amongst others. Physiologically, I must have a very regular cycle. Nonetheless, this birth was definitely not ordinary.
This is also my third OP baby, which means the baby presents face up rather than face down. My girls presented this way as well and eventually made their way out vaginally, refusing to turn and wanting to see the world on arrival rather than a blue plastic slide filled with poo and blood. I expected this guy would be the same because likely the shape of my pelvis promotes OP deliveries. And of course, he was.
My labour began in good old ordinary fashion. I was having fairly moderate contractions and some spotting, so I called Rithesh and we decided to head to South Health Hospital, where I was set to deliver. Luckily, we were already in Calgary staying with friends so it wasn't as bad of a drive as it could have been, given the weather was horrible. Rithesh drove down a snow covered Deerfoot trying to get us there swiftly and safely. It was late in the evening, so traffic was scarce, but there were definitely a few cars unaware of lanes or speed limits. We passed a Tahoe who flicked us off and I wanted to yell: "hey man, I'm in labour here."
On assessment at triage, I was 5cms and having irregular but moderate contractions. They admitted me. A couple hours later, the contractions were firmer and closer together, baby had descended but my water remained intact. We started the oxytocin and I got an epidural.
Initially all was well and we tried to rest. Then the nurse started popping in and out of the room, adjusting my position. Baby's heart rate was occasionally dipping, but bumping back up within seconds, so we tried left side lying. Initially, that seemed to work. I tried to rest again and not obsessively check the monitors and strip.
An hour or so later, they decided to break my water and within minutes, I was ready to start pushing. As I began pushing, his heart rate began dropping again and my obstetrician decided to try a vacuum. Well, he didn't like that either and we quickly agreed on an emergency c-section to get baby out.
Since it was an emergency c-section, I was put under with a general anesthetic and Rithesh wasn't allowed in the room. If you've met him, I'm sure you can imagine how well that went!
I've assisted on at least 30 c-sections during my training, but only a few truly emergent ones. It's such a different experience being the patient. Everything happened so quickly - within minutes literally. I can still see the flurry of nurses and doctors around me, lines being put in, the anesthetist counting me down, and one nurse trying to keep me focused on her rather than the chaos in the room.
When I woke up, which I found out later was 3 hours after I went into the OR, I could hear voices and words familiar to me as a physician (shock, DIC, amniotic embolus, ICU), and I wondered: are they talking about me? What happened? Where am I? Where's Rithesh? Where's the baby? I'm thirsty and starving. I think what I did say, ultimately, was: can I have my glasses? I'm feeling hungry.
The anesthetist said: "you gave us a little scare there." That didn't quite resonate for me until a few days later when I read up on what happened. Since I had laboured and baby was well engaged, getting him out took some maneuvering that unfortunately resulted in one uterine artery laceration and one being nicked. I lost almost 2 litres of blood and needed medication to help my blood pressure, which kept dropping. Yet once the bleeding was controlled, I stabilized and didn't require more intensive care after all. The human body is really a wonderful thing.
Fortunately, being in Calgary, there was a huge team of doctors to help both myself and the baby in the event of distress. They even did a cystoscopy in the OR to ensure my bladder and ureters were intact. I'm truly grateful for the experts in the room and the care I received.
I was wheeled back to our room, where Rithesh was waiting, calm and collected with baby in his arms; however, I honestly cannot imagine how stressful those 3 hours must have been for him. As physicians, our knowledge is both a blessing and a curse in these situations. We've all at least heard of cases that ended well, and some that did not. I'm grateful he had the baby to distract him as he waited patiently for updates.
After that, things settled. Other than the pain control, which was way worse than I ever imagined, and the overall fatigue, the rest of our stay was pretty standard. The little man latched on immediately when I took him in my arms. I'm lucky that he nurses like a champ, for it has made that transition to newborn parenting easier, despite the difficult start.
We're home now and adjusting to the new family dynamic. The hardest thing for me is accepting this recovery, which is far more challenging and longer than my previous deliveries. I move slowly, feel as though I'm swimming through a brain fog, struggle to stool with confidence, and want more than anything to be more active than my body will allow.
Yet I'm home with my loving family. Baby is healthy and every day gets a little easier. Soon I'll have a smiling scar when sporting a bikini.