Bailey's birth story (Canada)

I had a home birth planned for my second baby, as I did with my first, but at a 33w, 36w and 38w ultrasound my baby was confirmed breech. I was with a team of midwives but in Ontario midwives are prohibited from delivering breech [Note: Ontario midwives' scope of practice does allow breech births, but most hospitals do not allow midwives to attend breech births.] I had a consult with an OB at the local hospital who would "allow me to try a vaginal delivery." This consult did not leave me feeling good and I pursued other options. I learned that an amazing midwife, the only midwife in Canada with breech rights, was an hour away teaching other midwives and OBs how to deliver breech in an upright position. She was looking to take on clients so these providers could witness a breech birth in person. I contacted her and she agreed to take me as a client on Friday (38 +3) and early Sunday morning I went into labour (38+5). 

Contractions started at midnight and I timed them for a couple hours but weren't consistent and weren't increasing in strength. I walked around the hour for a bit and the contractions basically died off so I went back to sleep around 3am. When I woke up around 7am they were present again and more consistent but still 6 minutes apart. We called our new midwife and she said to go to the hospital to get checked out as it was an hour drive. My first birth progressed very quickly, it was 5 hours from spontaneous water breaking to baby and about 1 in active labour so we wanted to make sure I arrived at the hospital with time to spare. 

Once I got to the hospital I met with my new birth team for the very first time and confirmed by ultrasound that baby was still in a frank breech position. Contractions were still only 5 mins apart and I was estimated to be about 3cm dilated. Contractions were very manageable and I was able to easily talk and joke through them and between them. They said normally they wouldn't admit me as I was still in early labour but due to the circumstances they kept me. I didn't want to be in a hospital longer than necessary but I was happy to be able to chat with and get to know my birth team before things got more intense. 

Contractions slowly picked up and I was breathing through them but still pretty aware between them. I spent the next couple hours labouring in many different positions off of the bed. I was moving and walking around as a way to manage the contractions. With both my births I was unable to stay still during contractions; even during active labour I would walk at a pretty quick pace during the contractions and rest on a ball or my husband between them. When things started picking up I went in the birth tub and then the shower as a way to relieve the intensity. The birth tub was just a really long bathtub and I was unable to get comfortable in it, so it did not provide relief like the blow up pool during my first birth did. I got out and laboured leaning on the bed and rocking through the contractions instead of walking. I felt very focused at this point and was able to use my breathing to ease the contractions. 

Then I had one very strong contraction that caused a spasm up my ribs and in my armpit that was by far the most painful one of the entire process. It really caught me off guard and I felt like I lost my groove at that point due to the surprise pain in such an unusual place. I felt so out of control and really struggled to center myself once I lost it. My water bag was bulging through my cervix creating super intense contractions and so much pressure. It had started very early in my labour and got worse as things progressed. During transition I was labouring in the shower leaning over the side of my husband. I felt very hot and got out and onto the bed. I laboured leaning on the upright bed and then on my hands and knees. At this point I was in full transition mode and was saying I couldn't do it and I just wanted it to be over. Every time I would feel a contraction I would start crying and panicking thinking about the pain. 

While on the bed I got the urge to push and pushed a couple times and finally my water broke. The relief was instant and for the first time in about an hour I was able to relax. I didn't realize that I had been feeling constant pain even in between contractions until it was gone. The urge to push got super intense and I literally roared through each contraction. 

Before my water broke, baby was still very high above my cervix so it took some pushes to bring her further down. I was on my hands and knees so with each contraction I would rock back and forth and use my movement to help baby descend. I felt her come through the cervix so I put my hand inside me to feel baby come closer to me with each contraction. 

Once she was rumping I kept my hand on her to feel the progress I was making. My midwives were sitting back quietly and letting me do what my bony needed. They remained hands off until they were necessary to intervene. With each urge to push I was breathing out and making super low sounds that helped me focus. 

When baby was born past the umbilical cord but legs still folded inside I stopped having contractions. I relaxed while waiting for them to start again, I tried nipple stimulation and pushing without a contraction because I was ready for it to be over but it didn't bring on contractions. I was rocking and moving and my baby gave a big wiggle to help me out, which was a very weird sensation! 

After about 3 or 4 minutes I still didn't have another contraction so my midwife wrapped her arms around my upper belly and did fundal pressure which brought on a contraction and I was able to push baby's legs out. We waited for another contraction but again none came so we did more fundal pressure which did not seem to bring baby down. But after, I felt a small urge to push and I bore down as hard as I could and moved baby lower. She was now low enough that my midwife was able to sweep the arms out and then used a Frank's nudge [shoulder press] to deliver the head. Baby was passed through my legs and placed on the bed. I rubbed her and gave her kisses. The placenta was delivered minutes after baby and I had no tearing. 

During the birthing phase a paediatric team was on standby in the room as per hospital protocol. Her tone wasn't good so the cord was cut immediately and she was taken to the paediatric table. PPV was started with room air and after 1.5 minute they started oxygen. Baby took her first breath at 2mins but was still not consistent. Her oxygen saturation was normal so they decreased to 50% oxygen then room air. At 4mins she was consistently breathing on her own and was transitioned to CPAP. Her heart rate throughout was above 100bpm, her colour and tone improved but were still slightly below normal. Her APGARS were 3,6, then 8. 

Due to her increased work of breathing and needing the CPAP, she was transferred to the NICU. Baby was wrapped in a blanket and given to me to hold for a very short period of time before being taken to the NICU. In the NICU her CPAP was just on room air. Daddy went with her and I got to meet her an hour and a half later. I didn't realize so much time had passed between her birth and me meeting her. It honestly felt like 10 minutes so I couldn't believe it had been that long. She was taken off CPAP at 2 hours old and I was able to establish breastfeeding and finally do skin to skin. At 5 hours old she was discharged from NICU and went back to the hospital room with us. 

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