We had been trying Moxibustion, acupuncture, chiropractor, homeopathic pills and various positions to get him to turn but I was pretty sure he was still head-up.
At my midwife appointment the day before (Feb 5th), she checked his heartbeat with the fetal scope and based on it alone, it indicated that he was head down, since his heart beat could be heard best in the lower quadrant of my belly. We were pretty sure he still had his head in my ribs though. Also, my blood pressure was good and I had no protein in my urine.
The plan was for us to go for the ultrasound in the morning. Assuming baby had grown enough (weighing over 2500g), my midwife would immediately request an OB consult for the External Cephalic Version- ECV. I was told to not eat or drink anything after 8:00am as they won’t do the procedure if you’ve had food in case you need a cesarean.
We went for the ultrasound at 9:45am. Hubby also had to get a chest X-ray at the same time to rule out pneumonia or chest infection since he had been quite sick for the past 10 days. Kill two birds with one stone! It came back negative so that’s good.
Before the ultrasound, the nurse took my blood pressure and it was a bit high, 140 over 90. My blood pressure had been good up until my last 2 days of work the week before- probably from all the stress of finishing work and the unknown of Leo being breech and small for gestational age. The nurse made a big deal about it and said she would check it again after the ultrasound.
The ultrasound itself was pretty uneventful. We could tell based on the measurements that he had grown, just not sure if it was enough, and he was indeed still breech. The tech was pretty quick and made a comment about showing the results to the doctor and being happy about them.
We went to a consult room where the nurse came in again to check my blood pressure- no change, still borderline high. A few minutes later the doctor came with a sympathetic look on her face and said that baby is fine but due to my high blood pressure we should probably look into delivering him that day. She said they would page our midwives and let them know the results.
Of course this was not the news I wanted to hear, other than him being ok of course, so I shed a few tears. We were prepared this time with the car seat installed and the hospital bag, jokingly saying that if we bring it all we won’t need it. Looks like that wasn’t the case!
We paged the midwives ourselves after we left the clinic and N said to give her 15 minutes while she called around to the hospitals for an OB consult. She definitely calmed me down- the doctor and nurse had put me into panic mode. No wonder my blood pressure was high!
N phoned back and said the South Health Campus hospital that we had gone to for the consult last week was full so we were heading to the Foothills hospital, where Audrey was born almost two years ago.
We arrived around 11:00am, with N and the midwife student, E, waiting for us. They took us up to the Labour and Delivery floor and checked us into a private triage room. Baby and I were hooked up to monitors and of course my blood pressure was way lower. Apparently I get “white coat” syndrome. N put us both at ease that we were just checking the baby, watching my blood pressure, requesting a consult for the ECV and didn’t immediately need to have a cesarean. That made me feel way better and I’m sure helped bring my blood pressure down.
They ran a few blood tests and so far baby and I were looking great on the monitors. We had a few OB residents come by and one medical student who unintentionally created a lot of comic relief for us! The first OB resident was great- she listened to our request for an ECV, reviewed our chart and gave us some positive feedback.
Some time later, the student came in looking for lab results - he wasn’t unprofessional, but very much a “dude” kind of guy, very laid back. He commented that the OB on call was just finishing up with someone else, and that they’d most likely try the ECV with a spinal, which was in line with what we were hoping. Our spirits were up- we had some choices available.
Moments later, the second OB resident came in and she immediately said “so it looks like we’re having a baby today!” She went on to explain that we had to have a baby via cesarean that day since my blood pressure was getting higher, baby was small and there was no benefit to him being in anymore. That took us by surprise since we thought trying the ECV was still on the table, and my blood pressure was getting lower and lower, not higher!
I questioned her, hubby questioned her, and N questioned her about that assessment, pointing out and detailing the other conversations we’d had over the nearly 3 hours we’d been in triage with the rest of her team. She seemed a bit surprised and at first insistent that we should have the baby that day… but by the time she left, she conceded that the OB on call might be willing to attempt the ECV. As she left the room, my midwife N was hot on her heels, and set her straight about not communicating with the rest of the team and presenting us with only one option when clearly the rest of the team said otherwise. I’m forever grateful that one of our midwives was there to advocate for us since sometimes talking to the doctors can be intimidating.
The OB resident came back in a few minutes even more open to the ECV and “clarified” that my blood pressure was borderline high and it’s with consistently high blood pressure that they recommend immediate delivery, by cesarean in my case due to baby being breech.
It was around this time that I started getting more consistent, regular braxton hicks/contractions. They weren't painful but they were definitely noticeable to me and obviously on the monitors.
A little while later, the OB on call came in and immediately she put us all at ease with expert bedside manner. She sat down beside me and took the time to talk about the different options available to us, what she recommended and why, and where we had some ability to choose, and was just very compassionate about the change in events.
She explained why high blood pressure wasn’t a good thing, especially in full term pregnancies. She said that even though mine wasn’t super high, it was a sign that my body wasn’t tolerating the pregnancy anymore and due to baby being mid/full term there wasn’t really any benefit to him being in any longer. Something could change quickly for the worse and the cons outweighed the benefits of him being in for both of us.
She gave us these options:
1) Try the ECV with a spinal. Usually it’s done without any pain medication but recent studies have shown that it’s more effective if done under a spinal so that the OBs can really manipulate the baby from the outside without causing discomfort to the mother. It’s also good in that if something did go wrong during the procedure, you are already prepped for a cesarean. Without the spinal, in case of emergency, the mother has to be put under general anesthesia, and miss the birth of her baby. Not what I wanted at all and my biggest hesitation with the ECV procedure.
2) a) If the ECV worked, she recommended breaking my water and inducing labour that way. This way we know baby is head down and there isn’t the risk that he will turn breech again before labour starts naturally.
2) b) If the ECV is successful, she also gave us the option to not break my water, but I would need to be monitored daily for my blood pressure and regular ultrasounds to make sure that baby is still growing adequately.
3) If the ECV is not successful, they would just do a cesarean right away since the spinal is already in place and there weren’t any benefits of keeping him in any longer anyway.
4) Decline the ECV and book a cesarean in the next few days and/or hope baby flips on his own.
Finally some options!! Hubby and I discussed them and decided that we would go ahead with the ECV with spinal. However, if it worked, we did not want them to break my water. We would go with regular monitoring and hope that labour would start on it’s own when baby was ready to come out. We felt that breaking the waters could be one intervention that could lead to others, including a cesarean. We share the philosophy of minimal intervention - that is, use the medical resources when necessary, but only when necessary, because women’s bodies need to be given the chance to do something we are designed to do. It’s just great to have the latest science available if we or our babies need it.
If the ECV did not work, we decided he would be born via cesarean right away. If it didn’t work, there must be a reason and there was no point in delaying the inevitable.
Once we made the decision, things started to happen quickly! Hubby contacted his brother and sister-in-law to pick up Audrey that afternoon since regardless of the outcome, we would still be at the hospital for a few more hours.
The anesthesiologist came into the room and I wasn’t sure if I should laugh or be scared! He was a middle aged man, but my initial thought when he started talking was to ask to see his medical degree! I couldn’t tell if he was asking me a question because he didn’t know the answer to it or if it was just his way of confirming my understanding and consent of the procedure! Either way it was entertaining! Hubby thought he was either high, just woke up, or just very odd. His manner was somewhat comforting as the procedure progressed though.
Even though I hadn’t had any food or water since 8:00am, and it was now about 2:30pm, he still gave me a nasty drink in case I needed general anesthesia. He asked me if I had a lot of heartburn in this pregnancy, which I really hadn’t but I thought it was funny that he asked that question since he originally said I didn’t need to take the drink but after he asked the question he told me to drink it! Sadly, I was so parched that as gross as the drink was, it was nice to wet my mouth!
Quickly, everyone was suited up into their scrubs. My midwife and her student were allowed in the OR which made me feel so much better having someone I know and trusted there.
We walked to the OR and Hubby waited in a small observation area until they had me prepped for the ECV.
There was a whole crew of people in the OR waiting for us. They had a team on hand in case I did have a cesarean to help with the surgery, as well as the anesthesiologist, the OB, the OB resident, the medical student, a nurse for me, and my 2 midwives. It was a party!
I don’t know for sure, but I imagine the prep for the ECV with a spinal was the same as for a scheduled cesarean. The anesthesiologist put in the spinal, while I held onto my midwife. It definitely hurt more this time than when I had the epidural with Audrey- likely because I didn’t have contractions to distract me from the needle pain! I wasn’t scared about it though since I didn’t find it that bad when I had Audrey. It just seemed to take longer to administer.
Fairly quickly my legs went numb and they laid me down. It kind of felt like going to the dentist when you get freezing. I started to feel nauseous and almost faint so the anesthesiologist gave me some medicine to help with that. I felt really out of it when they let Hubby into the room finally but the medicine helped. I started to get the shakes too. Full body shakes which is a side effect of the spinal.
In no time at all, they started the ECV. I could feel extreme pressure on my belly- so glad I didn’t do it without the spinal! The OB used her one hand and had the ultrasound wand on my belly the entire time. The OB resident used her two hands. It was pretty intense- I could definitely feel him being moved! They got him about halfway but when they let go, he popped back up to breech again. His heart rate dropped a bit, enough to let us know that he wasn’t happy about the move. The OB declared the ECV was not going to work and we were going to have a baby.
I was slightly relieved because it meant that the whole thing was going to be over and our baby would finally be here. Maybe, or definitely, not how I wanted him to come but we had literally tried everything we could and we had no other alternative.
I was anxious for the c-section but Hubby was great at keeping me calm and trying to distract me from the tugging and pulling I could feel. Even though I didn’t feel any pain I definitely could feel what the OB was doing.
In a matter of minutes, he was born! He came out wailing! Sure enough, as I suspected, he had a very short cord and it was wrapped around his neck. He couldn’t turn!!
Leo Stephen Louis N was born at 3:40pm, February 6th, 2014, weighing 5 lbs, 15 oz and 20 inches long.
Our midwives looked him over, while he continued to protest his eviction and informed us that he was perfectly fine. N brought him over to us and laid him on my chest while I was being stitched up.
Although Leo was born by c-section - not my “dream birth story” - I feel better about it because of the journey we went through with the help of our midwives. I don’t feel like it was a procedure done to me, as much as it was a choice we made after exhausting all other avenues. And at least I didn’t have 24 hours of labour like I did with Audrey!
February 6th ended up being a very significant day for Leo to be born. It was the one year anniversary of the passing of Hubby’s beloved Grandpa. We had already decided ahead of time that Louis would be one of his middle names after Hubby’s Grandpa and it made it even more special that he was born on this day.
Stephen is a family name on Hubby’s paternal side. It’s his, his dad’s and Grandpa’s middle name, and his Great-Grandpa’s first name.
Leo is a name that we both really liked and turns out there is family significance as well. Leo was the name of Grandpa Louis’ favourite uncle.
After they stitched me up, they moved me to recovery. I was still mostly frozen but quite wide awake. I was desperate for some water since I was so thirsty but they were even hesitant to give me ice chips until the spinal wore off. It was sweet relief when I finally got some ice chips!
Even though Leo was frank breech, he didn't keep his legs up by his ears for very long. This is the only time I saw them at all close to his ears. They will still check his hips for the next couple of months to make sure there aren't any issues from being breech but it looks positive right now that he won't have any issues.
Not long after we arrived in recovery, I did skin to skin with Leo and he started rooting right away. Such a boy!! I was so relieved because often c-sections can lead to issues breastfeeding.
Once we had recovered enough (not sure how long we were actually in recovery for), they moved us into a private room in postpartum. I was so happy because last time I had a shared room and it was hell. I don't know what I would have done if I had to share a room this time.
We also started the processing of informing family and friends that Leo had arrived! They knew we were going in for an ultrasound that morning but no one was expecting him to be born that day, least of all us! We didn't tell people about the ECV plan with c-section back up because we didn't have time, other than to make arrangements for Audrey.
Everyone was pretty shocked! We weren't expecting him for at least another week. They were excited and happy he was here safe and sound.
We spent the evening cuddling with Leo and getting acquainted with our new little man. We were shocked that we woke up thinking it was going to be a regular day and ended it with this tiny, perfect addition to our family.
And so life with two begins!